Notice of Privacy Practices

BraveWorms Medical, P.C. ("the Practice") and the licensed clinicians, employees, and contractors who provide care under its supervision.

For treatment

We use your health information to provide and coordinate your care, for example, to evaluate symptoms, order labs or imaging, prescribe medication, and consult with another clinician about your case.

For payment

We use your information to process payment for your visit. The Practice does not bill insurance; you may submit a "superbill" we provide to your insurer at your option.

For health care operations

We use information for quality review, clinician training, compliance audits, accreditation, and similar internal operations.

Other permitted uses without authorization

• Public health activities (reportable conditions, FDA safety reports).
• Health oversight, lawful subpoenas, and judicial proceedings.
• To avert a serious and imminent threat to health or safety.
• For workers' compensation, where applicable by law.
• To business associates under written Business Associate Agreements (e.g., the EHR vendor, e-prescribe service, secure messaging).

• Most uses or disclosures of psychotherapy notes.
• Marketing communications, beyond face-to-face encounters or a small promotional gift of nominal value.
• Any sale of protected health information.
• Any use or disclosure not otherwise permitted by HIPAA or California law.

• HIV test results, mental health records, genetic information, substance use disorder records, and reproductive and sexual health information receive heightened protection under California law and 42 C.F.R. Part 2.
• You have the right to receive copies of your records within 15 business days of a written request and to inspect them within 5 business days (Cal. Health & Safety Code § 123110).
• The Practice will not disclose medical information without your written authorization except as permitted by the Confidentiality of Medical Information Act (Cal. Civ. Code §§ 56.10–56.16).

• Inspect and copy your record (we may charge a reasonable, cost-based fee).
• Request an amendment if you believe information is inaccurate.
• Receive an accounting of certain disclosures we have made in the previous six years.
• Request restrictions on certain uses and disclosures (we will accommodate when required by law).
• Request confidential communications by alternative means or at alternative locations.
• Receive a paper copy of this notice on request, even if you have agreed to receive it electronically.
• Be notified of a breach of unsecured PHI consistent with 45 C.F.R. §§ 164.400–414 and Cal. Civ. Code § 1798.82.

To exercise any right, contact our Privacy Officer (below).

• We are required by law to maintain the privacy of your PHI, to provide you this notice, and to abide by its terms currently in effect.
• We reserve the right to change this notice and to make the new terms effective for all PHI we maintain. The current version will be posted at this URL with an effective date.

You may file a complaint with us at no cost and without retaliation. You may also file with:

• U.S. Department of Health and Human Services, Office for Civil Rights: hhs.gov/ocr/complaints
• California Department of Justice, Office of Health Information Integrity: oag.ca.gov
• Medical Board of California: mbc.ca.gov

[Privacy Officer name], [title]
BraveWorms Medical, P.C.
4251 Long Beach Blvd, Suite 102, Long Beach, CA 90807
privacy@braveworms.com

• Telehealth Informed Consent
• No Surprises Act and Good Faith Estimate
• Website Privacy Policy (governs information collected outside clinical care)